Esquisse d'une anthropologie clinique II. Les comportements psychopathologiques comme formes de vie, pensés à l'articulation du fonctionnement neurobiologique, de l'intériorité subjective et des formes symboliques

Un précédent article a présenté les deux démarches fondant l'anthropologie clinique : l'anthropopsychiatrie de Jacques Schotte, qui permet d'inscrire la clinique dans le champ de l'anthropologie, et l'anthropologie sémiotique formulée par Jean Lassègue, Victor Rosenthal et Yves-Marie Visetti, qui dote cette même clinique, grâce à la notion de forme symbolique, de moyens rigoureux pour assurer sa démarche scientifique. Dans ce deuxième article, les auteurs commencent par dégager le potentiel intégratif de l'anthropologie clinique en explicitant la structure de l'humain et le cadre épistémologique qui organisent ce nouveau paradigme. Puis, se référant plus précisément à certaines formes cliniques psychiatriques contemporaines, ils montrent comment on peut bien les comprendre quand on les pense comme des formes de vie, à l'articulation du fonctionnement neurobiologique, de l'intériorité subjective et des formes symboliques. Éclairage valable, selon les auteurs, pour penser tout le champ de la psychopathologie et des soins s'y référant. A previous article presented the two foundational approaches of clinical anthropology : Jacques Schotte's anthropopsychiatry, which inscribes clinics in the field of anthropology, and semiotic anthropology as formulated by Jean Lassègue, Victor Rosenthal and Yves-Marie Visetti, which provides this same clinics, through the notion of symbolic form, with rigorous instruments to ensure its scientific approach. In this second article, the authors begin by highlighting the integrative potential of clinical anthropology through a clarification of the human structure and the epistemological framework that organize this new paradigm. Then, referring specifically to some contemporary psychiatric clinical forms, they show how well they can be understood when they are considered as life forms of subjective interiority and symbolic forms, at the articulation of neurobiological functioning. According to the authors, this approach shed a useful light for thinking the entire field of psychopathology and related care forms.

The Subjective Sensation of Synchrony: an Experimental Study

People performing actions together have a natural tendency to synchronize their behavior. Consistently, people doing a task together build internal representations not only of their actions and goals, but also of the other people performing the task. However, little is known about which are the behavioral mechanisms and the psychological factors affecting the subjective sensation of synchrony, or "connecting" with someone else. In this work, we sought to find which factors induce the subjective sensation of synchrony, combining motion capture data and psychological measures. Our results show that the subjective sensation of synchrony is affected by performance quality together with task category, and time. Psychological factors such as empathy and negative subjective affects also correlate with the subjective sensation of synchrony. However, when people estimate synchrony as seen from a third person perspective, their psychological factors do not affect the accuracy of the estimation. We suggest that to feel this sensation it is necessary to, first, have a good joint performance and, second, to assume the existence of an attention monitoring mechanism that reports that the attention of both participants (self and other) is focused on the task.

Psychometric Properties of the Personal Wellbeing Index in Brazilian and Chilean Adolescents Including Spirituality and Religion = Propriedades Psicométricas do Personal Wellbeing Index em Adolescentes Brasileiros e Chilenos Incluindo Espiritualidade e Religião

This study compared the 7-item Personal Wellbeing Index (PWI) with two other versions which include the domains “Spirituality” and “Religion”, separately, in a sample of Brazilian (n = 1.047) and Chilean (n = 1.053) adolescents. A comparison of psychometric properties between the PWI versions was carried out through multigroup confi rmatory factor analysis showing adequate adjustments (CFI > .95, RMSEA < .08), whereas the item spirituality presented better performance. For the analysis of the differential contribution of each domain to the notion of global satisfaction, a regression on the item Overall Life Satisfaction (OLS) was applied using structural equations. It isrecommended the inclusion of the item spirituality in the original scale, considering the importance of such domain in both cultures

Design and implementation of a leisure program to improve function and wellbeing in people with depressive disorder

Depression is a major cause of disability and disease with significant costs to the health system and for the whole society. Regarding the treatment, in recent years has questioned the effectiveness of antidepressant drugs, with a recognition that although depressive disorders tend to improve with these treatments, residual symptoms seems to be still the norm, which is associated with the risk of new episodes or relapses, and faster its appearance. Otherwise many of the specialized clinical guidelines, propose a based on stepped-care model intervention, prioritizing less intrusive actions, including low-intensity psychosocial-interventions.

School-based Drama Program to Enhance Social and Emotional Wellbeing at Elementary School

Julkaisumaa: Hong Kong

Effects of physical activity and fitness on the psychological wellbeing of young men and working adults: associations with stress, mental resources, overweight and workability

Background: A positive association has been suggested to exist between physical activity and psychological wellbeing. However, the association between physical fitness, especially muscle fitness and psychological wellbeing, has not yet been fully elucidated. Aims: The objective of the present thesis was to assess the relationship between physical activity and physical fitness with stress symptoms, mental resources and workability among young men and working adults. Subjects and methods: Volunteers of young men (n=831, mean age 25-y (±4.0)), underwent a cardiorespiratory (CRF) and muscle fitness (MFI) test and completed leisure time physical activity (LTPA) and Occupational Stress Questionnaires (OSQ). The participants were divided into tertiles according to LTPA, CRF and MFI. A 12-month exercise intervention evaluated 371 working adults (exercise group, n=338, mean age 45-y (±8.8)); control group, n=33, mean age 41-y (±6.9)).The exercise group underwent a 12-month exercise program followed by a 12-month follow-up. The OSQ, Workability Index (WAI) and CRF were evaluated at baseline and at 4, 8, 12 and 24 months. Results: Physically inactive subjects reported more stress and less available mental resources than the subjects who reported high physical activity levels. Improved physical fitness was associated with less stress and more mental resources among normal weight men, but not in overweight men. After a 12-month exercise intervention, employees in the exercise group increased their physical activity, improved workability, decreased stress symptoms and improved their physical fitness and mental resources. After the follow-up year, workability and stress were improved compared to baseline. Conclusions: In this thesis, good physical fitness was associated with improved psychological wellbeing among young men and working adults.

Social Solidarity and Fear of Crime - Community and Individual Approaches in Responses to Mass Violence after School Shootings

The aim of this study was to examine community and individual approaches in responses to mass violence after the school shooting incidents in Jokela (November 2007) and Kauhajoki (September 2008), Finland. In considering the community approach, responses to any shocking criminal event may have integrative, as well as disintegrative effects, within the neighborhood. The integration perspective argues that a heinous criminal event within one’s community is a matter of offence to collectively held feelings and beliefs, and increases perceived solidarity; whereas the disintegration perspective suggests that a criminal event weakens the social fabric of community life by increasing fear of crime and mistrust among locals. In considering the individual approach, socio-demographic factors, such as one’s gender, are typically significant indicators, which explain variation in fear of crime. Beyond this, people are not equally exposed to violent crime and therefore prior victimization and event related experiences may further explain why people differ in their sensitivity to risk from mass violence. Finally, factors related to subjective mental health, such as depressed mood, are also likely to moderate individual differences in responses to mass violence. This study is based on the correlational design of four independent cross-sectional postal surveys. The sampling frames (N=700) for the surveys were the Finnish speaking adult population aged 18–74-years. The first mail survey in Jokela (n=330) was conducted between May and June 2008, approximately six months from the shooting incident at the local high-school. The second Jokela survey (n=278) was conducted in May–June of 2009, 18 months removed from the incident. The first survey in Kauhajoki (n=319) was collected six months after the incident at the local University of Applied Sciences, March– April 2009, and the second (n=339) in March–April 2010, approximately 18 months after the event. Linear and ordinal regression and path analysis are used as methods of analyses. The school shootings in Jokela and Kauhajoki were extremely disturbing events, which deeply affected the communities involved. However, based on the results collected, community responses to mass violence between the two localities were different. An increase in social solidarity appears to apply in the case of the Jokela community, but not in the case of the Kauhajoki community. Thus a criminal event does not necessarily impact the wider community. Every empirical finding is most likely related to different contextual and event-specific factors. Beyond this, community responses to mass violence in Jokela also indicated that the incident was related to a more general sense of insecurity and was also associating with perceived community deterioration and further suggests that responses to mass violence may have both integrating and disintegrating effects. Moreover, community responses to mass violence should also be examined in relation to broader social anxieties and as a proxy for generalized insecurity. Community response is an emotive process and incident related feelings are perhaps projected onto other identifiable concerns. However, this may open the door for social errors and, despite integrative effects, this may also have negative consequences within the neighborhood. The individual approach suggests that women are more fearful than men when a threat refers to violent crime. Young women (aged 18–34) were the most worried age and gender group as concerns perception of threat from mass violence at schools compared to young men (aged 18–34), who were also the least worried age and gender group when compared to older men. It was also found that concerns about mass violence were stronger among respondents with the lowest level of monthly household income compared to financially better-off respondents. Perhaps more importantly, responses to mass violence were affected by the emotional proximity to the event; and worry about the recurrence of school shootings was stronger among respondents who either were a parent of a school-aged child, or knew a victim. Finally, results indicate that psychological wellbeing is an important individual level factor. Respondents who expressed depressed mood consistently expressed their concerns about mass violence and community deterioration. Systematic assessments of the impact of school shooting events on communities are therefore needed. This requires the consolidation of community and individual approaches. Comparative study designs would further benefit from international collaboration across disciplines. Extreme school violence has also become a national concern and deeper understanding of crime related anxieties in contemporary Finland also requires community-based surveys.

Effect of melatonin administration on subjective sleep quality in chronic obstructive pulmonary disease

Disturbed sleep is common in chronic obstructive pulmonary disease (COPD). Conventional hypnotics worsen nocturnal hypoxemia and, in severe cases, can lead to respiratory failure. Exogenous melatonin has somnogenic properties in normal subjects and can improve sleep in several clinical conditions. This randomized, double-blind, placebo-controlled study was carried out to determine the effects of melatonin on sleep in COPD. Thirty consecutive patients with moderate to very severe COPD were initially recruited for the study. None of the participants had a history of disease exacerbation 4 weeks prior to the study, obstructive sleep apnea, mental disorders, current use of oral steroids, methylxanthines or hypnotic-sedative medication, nocturnal oxygen therapy, and shift work. Patients received 3 mg melatonin (N = 12) or placebo (N = 13), orally in a single dose, 1 h before bedtime for 21 consecutive days. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness was measured by the Epworth Sleepiness Scale. Pulmonary function and functional exercise level were assessed by spirometry and the 6-min walk test, respectively. Twenty-five patients completed the study protocol and were included in the final analysis. Melatonin treatment significantly improved global PSQI scores (P = 0.012), particularly sleep latency (P = 0.008) and sleep duration (P = 0.046). No differences in daytime sleepiness, lung function and functional exercise level were observed. We conclude that melatonin can improve sleep in COPD. Further long-term studies involving larger number of patients are needed before melatonin can be safely recommended for the management of sleep disturbances in these patients.

Subjective, behavioural and electrophysiological measurements of the time-course and intensity of sleep inertia after a full night of sleep /

Several recent studies have described the period of impaired alertness and performance known as sleep inertia that occurs upon awakening from a full night of sleep. They report that sleep inertia dissipates in a saturating exponential manner, the exact time course being task dependent, but generally persisting for one to two hours. A number of factors, including sleep architecture, sleep depth and circadian variables are also thought to affect the duration and intensity. The present study sought to replicate their findings for subjective alertness and reaction time and also to examine electrophysiological changes through the use of event-related potentials (ERPs). Secondly, several sleep parameters were examined for potential effects on the initial intensity of sleep inertia. Ten participants spent two consecutive nights and subsequent mornings in the sleep lab. Sleep architecture was recorded for a fiiU nocturnal episode of sleep based on participants' habitual sleep patterns. Subjective alertness and performance was measured for a 90-minute period after awakening. Alertness was measured every five minutes using the Stanford Sleepiness Scale (SSS) and a visual analogue scale (VAS) of sleepiness. An auditory tone also served as the target stimulus for an oddball task designed to examine the NlOO and P300 components ofthe ERP waveform. The five-minute oddball task was presented at 15-minute intervals over the initial 90-minutes after awakening to obtain six measures of average RT and amplitude and latency for NlOO and P300. Standard polysomnographic recording were used to obtain digital EEG and describe the night of sleep. Power spectral analyses (FFT) were used to calculate slow wave activity (SWA) as a measure of sleep depth for the whole night, 90-minutes before awakening and five minutes before awakening.

Investigating a dynamic modular framework for subjective well-being

According to Diener (1984), the three primary components of subjective well-being (SWB) are high life satisfaction (LS), frequent positive affect (P A), and infrequent negative affect (NA). The present dissertation extends previous research and theorizing on SWB by testing an innovative framework developed by Shmotkin (2005) in which SWB is conceptualized as an agentic process that promotes and maintains positive functioning. Two key components ofShmotkin's framework were explored in a longitudinal study of university students. In Part 1, SWB was examined as an integrated system of components organized within individuals. Using cluster analysis, five distinct configurations of LS, P A, and NA were identified at each wave. Individuals' SWB configurations were moderately stable over time, with the highest and lowest stabilities observed among participants characterized by "high SWB" and "low SWB" configurations, respectively. Changes in SWB configurations in the direction of a high SWB pattern, and stability among participants already characterized by high SWB, coincided with better than expected mental, physical, and interpersonal functioning over time. More positive levels of functioning and improvements in functioning over time discriminated among SWB configurations. However, prospective effects of SWB configurations on subsequent functioning were not observed. In Part 2, subjective temporal perspective "trajectories" were examined based on individuals' ratings of their past, present, and anticipated future LS. Upward subjective LS trajectories were normative at each wave. Cross-sectional analyses revealed consistent associations between upward subjective trajectories and lower levels of LS, as well as less positive mental, physical, and interpersonal functioning. Upward subjective LS trajectories were biased both with respect to underestimation of past LS and overestimation of future LS, demonstrating their illusional nature. Further, whereas more negative retrospective bias was associated with greater current distress and dysfunction, more positive prospective bias was associated with less positive functioning in the future. Prospective relations, however, were not consistently observed. Thus, steep upward subjective LS trajectory appeared to be a form of wishful-thinking, rather than an adaptive form of selfenhancement. Major limitations and important directions for future research are considered. Implications for Shmotkin's (2005) framework, and for research on SWB more generally, also are discussed

Subjective Ambivalence and the Expression of Anti-Gay Bias

Univalent attitudes toward gay people have been widely studied, but no research to date has examined ambivalent (i.e., torn, conflicted) attitudes toward gay people. However, the Justification-Suppression Model (JSM; Crandall & Eshleman, 2003) proposes that ambivalence leads to biased expressions through intrapsychic processes which facilitate biased expression, particularly in contexts presenting strong justifications for expressing prejudice and weak pressures to suppress prejudice. I test these implications in the context of bias toward gay people. In Study 1, the measurement of ambivalence is examined in terms of both subjective ambivalence (i.e., the reported experience of “torn” attitudes) and calculated ambivalence (i.e., mathematical conflict between positive and negative attitude components). I find that higher subjective ambivalence is only associated with more negative attitudes toward gay people (and not positive attitudes toward gay people), and that higher subjective ambivalence predicts less gay rights support even after taking negative and positive attitudes toward gay people into account. Further, higher subjective ambivalence is associated with ideological opposition to gay people and more negative intergroup emotions (e.g., intergroup disgust). These findings suggest it is valuable to examine the unique component of subjective ambivalence separate from univalent negativity. Because calculated ambivalence measures are mathematically dependent upon a univalent negative measure, they cannot be examined separately from negativity. Therefore, subjective ambivalence is the focus of Study 2. The main goals of Study 2 were to determine why and when subjective ambivalence is related to bias. I examined the extent to which the negative relation between subjective ambivalence and opposition to anti-gay bullying can be accounted for by lower intergroup empathy and lower collective guilt, which may facilitate the expression of bias in keeping with the JSM. The relation between subjective ambivalence and anti-gay bullying opposition was examined within four social contexts based on a 2 (high vs. low offensiveness) x 2 (normatively unjustified vs. normatively justified) manipulation. I expected that higher subjective ambivalence would be most strongly related to lower intergroup empathy and collective guilt when there are the strongest justifications for bias expression, and that lower intergroup empathy and collective guilt would lead to less opposition to anti-gay bullying. Higher subjective ambivalence predicted less anti-gay bullying opposition. After accounting for positivity and negativity, the direct effect of subjective ambivalence was no longer significant, yet subjective ambivalence uniquely predicted intergroup empathy, which in turn predicted less anti-gay bullying opposition. These findings provide evidence that subjective ambivalence is largely negative in nature, but also presents evidence for a unique component of subjective ambivalence (separate from univalent attitudes) associated with low intergroup empathy and negativity. In contrast to previous research, I found very little evidence for the context-dependency of subjective ambivalence. Further research on subjective ambivalence, including subjective ambivalence toward other social groups, may expand our understanding of the factors leading to biased expressions.